Historical development of the systems of medical education and medical licensure and its effect on the evolution of medical schools in Japan / 医学教育

1) The historical development to date of the systems of medical education and medical licensure were reviewed, and the quantitative and qualitative evolution of medical schools was divided into 7 stages.2) In the early Meiji era, persons who had already practiced medicine could apply to receive a medical license. Until the Taisho era, medical licenses were granted either to graduates of medical universities and relevant special schools or to those who passed the national examination. Thus, the criteria for medical license were not uniform during this period.3) Before the end of World War II, medical schools aimed to improve the quality of medical education so that their graduates could receive medical licenses without taking the national examination and to raise their status to the level of universities. However, because the types of medical schools during this period varied and included imperial universities, colleges, and specialty schools, the quality of medical education also varied.4) After World War II, the introduction of the state examination for the license to practice medicine and a new university system standardized medical education to guarantee its quality.5) The quantitative expansion of the medical education occurred mainly in the 12 years after 1919, in the 7 years after 1939 and during the war, and in the 10 years after 1970, and, except for the years of violent change before 1887, the number of medical schools has otherwise remained stable.

Interaction between fibrates and statins--metabolic interactions with gemfibrozil.

An in vitro study was carried out in order to examine the metabolic basis of the interaction between fibrates and statins. Metabolic inhibition of statins was noted in the presence of gemfibrozil. However, increase in the unchanged form was fairly small for pitavastatin, compared with other statins. Several CYP enzymes were shown to be principally responsible for the metabolism of gemfibrozil in contrast to other fibrates. In the presence of gemfibrozil, a focal point was obtained in Dixon plots, demonstrating that there was inhibition of CYP2C8-, CYP2C9- and CYP3A4-mediated metabolism. We propose that the increase of plasma concentration caused by co-administration of gemfibrozil and statins is at least partially due to CYP-mediated inhibition.